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Visit Date: May 12, 2021 ID Number: 153164
Visit Count: Children Served: Provider opted out of answer Community Health Worker: SIC Other Staff

Consultation services Delivered

What type of Consultation was it? Phone or virtual consultation session
Get information on how to help me cover my basic needs (food – clothing – housing – medical attention) Answered: Yes

Healthy and Safe Environment Concerns

Child Development Concerns

Health Related Social Needs Concerns

HealthCare Concerns

How to help me cover my HRSN (e.g. food, transportation, housing, medical needs, employment). Answered: Yes
Coping with stressful situations. Answered: Yes
Resource-Referral Type(s).
Financial strain, Covid 19 Related Information
Consultation Duration

Start Time: 8:50 PM
End Time: 8:59 PM
Time Period: 15 mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Goal attained

Notes for this Consultation

Provider requested from her emergency funds $60 to pay for prescription medications change and gas for her car. Done. jce